Basic Information
Provider Information | |||||||||
NPI: | 1306173562 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STRICH | ||||||||
FirstName: | SHERYL | ||||||||
MiddleName: | FRIEDNER | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.P.M. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 6042 SIERRA SIENA RD | ||||||||
Address2: |   | ||||||||
City: | IRVINE | ||||||||
State: | CA | ||||||||
PostalCode: | 926033912 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9498543636 | ||||||||
FaxNumber: | 9498543637 | ||||||||
Practice Location | |||||||||
Address1: | 550 LOMAS SANTA FE DR | ||||||||
Address2: | SUITE B | ||||||||
City: | SOLANA BEACH | ||||||||
State: | CA | ||||||||
PostalCode: | 920751341 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8587556055 | ||||||||
FaxNumber: | 8587556785 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/09/2009 | ||||||||
LastUpdateDate: | 08/13/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | E2444 | CA | Y |   | Podiatric Medicine & Surgery Service Providers | Podiatrist |   |
No ID Information.